Zika cases and congenital syndrome associated with Zika virus reported by countries and territories in the Americas, 2015 - 2017 Cumulative cases Data as of 30 November 2017 2:00 PM EST a Confirmed congenital Autochthonous cases Deaths among Country/Territory b Population Imported cases Incidence Rate c syndrome associated with Zika Zika cases e,f Suspected Confirmed virus infectiond X 1000 North America Bermuda 0 0 6 0.00 0 0 71 Canada 0 0 523 0.00 0 1 36,284 United States of America1 0 226 5,304 0.07 0 98 325,296 Subtotal 0 226 5,833 0.06 0 99 361,651 Latin America and the Caribbean Latin America Mexico² 0 11,315 15 8.80 0 20 128,624 Central American Isthmus Belize 2,005 355 0 636.12 0 0 371 Costa Rica³ 7,692 2,002 32 198.61 0 6 4,881 El Salvador 11,761 51 0 192.16 0 4 6,147 Guatemala⁴ 3,907 1,032 0 29.62 0 140 16,674 Honduras⁵ 32,385 308 0 399.18 0 8 8,190 Nicaragua 0 2,795 3 45.20 0 2 6,184 Panama 5,646 1,222 42 172.13 0 16 3,990 Subtotal 63,396 7,765 77 153.24 0 176 46,437 Latin Caribbean Cuba 0 187 58 1.64 0 0 11,392 Dominican Republic⁶ 4,919 335 0 49.07 0 85 10,708 French Guiana⁷,⁸ 10,500 483 10 3979.35 0 1 276 ⁷,⁹ Guadeloupe 30,845 382 0 6615.89 0 5 472 Haiti13 2,955 5 0 27.12 0 1 10,916 Martinique⁷,¹⁰ 36,680 21 0 9267.93 0 5 396 Puerto Rico¹¹ 0 40,562 137 1101.93 5 47 3,681 Saint Barthelemy⁷ 1,005 61 0 10660.00 0 0 10 ⁷,¹² Saint Martin 3,283 200 0 9675.00 0 1 36 Subtotal 90,187 42,236 205 349.52 5 145 37,887 Andean Area Bolivia (Plurinational State of) 2,617 790 4 31.05 0 14 10,971 Colombia¹⁴ 98,669 9,925 0 223.21 0 248 48,650 Ecuador¹⁵ 3,863 2,377 15 37.80 0 7 16,506 Peru¹⁶ 7,366 1,530 22 27.83 0 0 31,970 Venezuela (Bolivarian Republic of) 60,146 2,413 0 198.49 0 0 31,518 Subtotal 172,661 17,035 41 135.87 0 269 139,615 Brazil17 231,725 137,288 0 176.10 11 2,952 209,553 Southern Cone Argentina18 539 277 41 1.85 0 5 44,060 Chile 0 0 34 0.00 0 0 18,131 Paraguay¹⁹ 691 20 0 10.57 0 2 6,725 Uruguay 0 0 1 0.00 0 0 3,444 Subtotal 1,230 297 76 2.11 0 7 72,360 Non-Latin Caribbean Anguilla 31 23 1 317.65 0 0 17 Antigua and Barbuda20 540 25 2 601.06 0 0 94 Aruba 1,208 703 7 1676.32 0 0 114 Bahamas21 531 25 3 140.76 0 0 395 Barbados²² 715 150 0 296.23 0 1 292 Bonaire, St Eustatius and Saba23 235 437 0 2688.00 0 0 25 Cayman Islands24 237 30 11 460.34 0 0 58 Curacao25 4,476 2,049 0 4379.19 0 0 149 Dominica 1,154 79 0 1666.22 0 0 74 Grenada 335 118 0 408.11 0 2 111 Guyana26 0 37 0 4.79 0 3 773 Jamaica 7,772 203 0 284.01 0 0 2,808 Montserrat 18 5 0 460.00 0 0 5 Saint Kitts and Nevis 554 33 0 1107.55 0 0 53 Saint Lucia 822 50 0 528.48 0 0 165 Saint Vincent and the Grenadines 508 83 0 579.41 0 0 102 Sint Maarten (Dutch part) 253 149 0 957.14 0 0 42 Suriname 2,768 724 0 637.23 4 4 548 Trinidad and Tobago27 0 718 1 52.52 0 17 1,367 Turks and Caicos Islands 203 25 3 438.46 0 0 52 Virgin Islands (UK) 74 53 0 362.86 0 0 35 Virgin Islands (US) 1,165 1,024 2 2125.24 0 0 103 Subtotal 23,599 6,743 30 411.03 4 27 7,382 TOTAL 582,798 222,905 6,277 80.29 20 3,695 1,003,509 SOURCE: Cases reported by the IHR National Focal Points to the WHO IHR Regional Contact Point for the Americas and through the Ministry of Health websites, 2016-17 NOTES: Data is shared in an effort to transparently disseminate available information reported by Member States. Any subsequent interpretation and analysis of this data should consider differences in surveillance systems and reporting requirements. Information may change as Member States review and integrate retrospective data. aPAHO/WHO Case definitions for suspected and confirmed Zika cases is available at: http://www.paho.org/hq/index.php?option=com_content&view=article&id=11117&Itemid=41532&lang=en b Incidence rate (autochthonous suspected + autochthonous confirmed) / 100,000 pop. c Deaths among Zika cases do not include deaths related to Guillain-Barré syndrome (GBS) or congenital malformations associated with Zika virus infection. As of 12 May 2016, previously reported deaths related to GBS were removed from this total. dConfirmed congenital syndrome associated with Zika virus infection case definition: Live newborn who meets the criteria for a suspected case of congenital syndrome associated with Zika virus AND Zika virus infection was detected in specimens of the newborn, regardless of detection of other pathogens. Case definitions for congenital syndrome associated with Zika virus infection is available at: http://www.paho.org/hq/index.php?option=com_content&view=article&id=11117&Itemid=41532&lang=en e Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2015 Revision, http://esa.un.org/unpd/wpp/index.htm, July 2015. Processed and revised by PAHO. Population by Sex and Age range for Countries and Territories of Americas 2017. http://www.paho.org/data/index.php/en/indicators/demographics-core/106-cat-data-en/336-poblacion-reg-en.html?showall=&limitstart Accessed on January 26, 2017. International Programs Center, Population Division, U.S. Census Bureau. IDB Release Date: December 2013. http://www.paho.org/data/index.php/en/indicators/demographics-core/106-cat-data-en/336-poblacion-reg-en.html?showall=&limitstart Accessed on January 26, 2017. Population source for Saint Barthelemy and Saint Martin available for 2016 (updated 31 December 2016) available at: Journal official de la République Francaise. https://www.legifrance.gouv.fr/jo_pdf.do?id=JORFTEXT000033748679 Accessed on January 26, 2017. Population source for Bonaire, Sint Eustatius and Saba for 2015 (updated 29 November 2016) available at: Caribisch Nederland; bevolkingsontwikkeling, geboorte, sterfte, migratie - 29 November 2016 http://statline.cbs.nl/StatWeb/publication/?DM=SLNL&PA=80539ned&D1=0-1,9-10&D2=a&D3=a&HDR=T&STB=G1,G2&CHARTTYPE=1&VW=T Accessed on January 26, 2017. f For countries and territories which reported their first Zika case in 2015, the population is based on the average between 2015-2017. For countries and territories which reported their first Zika case in 2016, the population is based on the average between 2016- 2017. For countries and territories which did not report Zika cases between 2015-2017, the population is based on the average between 2015-2017. 1 In addition to the 226 reported cases acquired through presumed local mosquito-borne transmission, 50 cases were acquired through other routes, including sexual transmission (N=48), laboratory transmission (N=1), and person-to-person transmission through an unknown route (N=1). As of 13 September 2017, 8 pregnancy losses with birth defects have been reported. Available at: http://www.cdc.gov/zika/geo/united-states.html ²On 11 September 2017, the Mexico Secretariat of Health reported 20 cumulative confirmed cases of congenital syndrome associated with Zika virus infection, one of which was stillborn. https://www.gob.mx/cms/uploads/attachment/file/255061/Desglose_Casos_Sx_Congenito_asociado_a_Zika.pdf ³The difference between the number of suspected (7639) and confirmed cases (1982) of Zika reported by 26 October 2017 with respect to the number of suspected (7635) and confirmed cases (1994) reported by 02 November 2017 is due to a retrospective adjustment of data by the Ministry of Health of Costa Rica. Available at: https://www.ministeriodesalud.go.cr/index.php/vigilancia-de-la-salud/boletines/3558-boletin-epidemiologico-no-40-2017-zika-chikungunya-y-dengue/file ⁴In the previous Zika update from the Guatemala Ministry of Public Health on 20 March 2017, a total of 59 cases of confirmed congenital syndrome associated with Zika virus infection were notified to PAHO / WHO (EW 32 of 2015 to EW 9 of 2017). On 25 May 2017, the Guatemala Ministry of Public Health notified 140 cases of confirmed congenital syndrome associated with Zika virus infection to PAHO/WHO (EW 32 of 2015 to EW 19 of 2017), of which 59 cases were newly reported cases between EW 14 and EW 18 of 2017. ⁵ On 30 August 2017, the Honduras Ministry of Health reported 10 confirmed and 379 suspected cases of Zika (EW 1 of 2017 and EW 33 of 2017), corresponding to a cumulative total of 308 confirmed and 32,385 suspected cases (EW 49 of 2015 to EW 33 of 2017). In addition, the Honduras Ministry of Health reported 6 cases of confirmed congenital syndrome associated with Zika virus infection (EW 1 of 2017 and EW 33 of 2017), corresponding to a cumulative total of 8 confirmed cases (EW 1 of 2016 to EW 33 of 2017) 6 The difference between the number of reported confirmed cases of Zika from 10 August 2017 (345 cases) to 21 August 2017 (335 cases) is due to retrospective adjustment of data by the Dominican Republic Ministry of Public Health and Social Assistance.